Hessen Proposes Temporary Increase to Pharmacy Discount in GKV Savings Law Debate
The German parliament is currently reviewing the GKV Contribution Rate Stabilisation Act, which aims to address a projected deficit of approximately 19 billion euros in the statutory health insurance system. As part of the legislative process, stakeholders were invited to provide input on the government's cost-saving measures, which are designed to keep health insurance premiums stable for the general population.
One of the key proposals affecting pharmacies is an increase in the mandatory discount pharmacies must provide to the statutory health insurance funds for each prescription medication dispensed. Effective from January, the discount per package is set to rise by 30 cents, increasing the current rate from 1.77 euros to 2.07 euros per prescription package. Unlike previous measures under the GKV Financing Stabilisation Act, which had a fixed duration, the current proposal does not include a sunset clause, meaning the increase would be permanent unless further legislation is enacted.
The Ministry of Health in the state of Hessen has taken a critical stance on the proposed permanent increase. According to a ministry spokesperson, Hessen has advocated in the Bundesrat, Germany's federal council, for a conditional approach: the state believes that any increase in the pharmacy discount should only occur if there is a corresponding rise in the fixed dispensing fee for pharmacies. The rationale is that an increased discount, without an offsetting adjustment to the fixed fee, could undermine the financial stability of community pharmacies.
During its review, Hessen supported the complete removal of the planned discount increase. However, in search of a compromise, the state has suggested the possibility of a temporary, time-limited increase. This approach would maintain the federal government's objective of ensuring all healthcare providers contribute to cost containment, while also safeguarding pharmacies from disproportionate economic strain. Such a solution would align with recommendations made by the Federal Union of German Associations of Pharmacists (ABDA), which has also called for a temporary measure rather than a permanent change in its formal feedback to the proposed savings law.
The ABDA, representing pharmacy interests nationwide, has generally opposed any increase in the pharmacy discount, arguing that an additional financial burden would erode recent improvements to the fixed dispensing fee. The association emphasizes that pharmacies are already facing significant economic challenges and that further cost pressures could negatively impact their role in the healthcare system.
Other German states have similarly voiced concerns about the planned increase, highlighting its potential impact and linking their position to the issue of the fixed remuneration for pharmacies. Despite these objections, the federal government has so far maintained its intention to implement the higher pharmacy discount as a permanent measure.
The ongoing parliamentary hearings and negotiations reflect the broader debate over how to equitably distribute the burden of health system savings among various healthcare providers, while ensuring the continued accessibility and financial viability of community pharmacies across Germany.